Management of rupture of membranes at term in low-risk obstetric population

Abstract EN

Objective : To compare the outcomes of expectant versus active management of patients presenting with premature rupture of membranes (PROM) at term.

Design : Observational case-controJ study over a period of 30 months.

Setting : King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia.

Subjects : All obstetric patients with no obstetric risk factors other than PROM at term were included in the present study.

Each patient was matched with a control case who had started labor with intact membranes.

Outcome Measures : Duration of Jabor, fetal distress, intrapartum pyrexia, rate of cesarean section delivery, and Apgar scores at birth.

Results : The duration of Jaborwas shorter in patients with PROM compared to the control group, but the difference was not statistically significant.

Furthermore, cesarean section rate was 4.5 % in the PROM group versus 7.6 % in the control group.

Among patients with PROM who received active management, the rates of intrapartum pyrexia and cesarean sections were almost twice that in patients who were managed expectantly.

Conclusion : In the absence of other maternal and / or obstetric risk factors, PROM does not seem to constitute additional obstetric risks.

Furthermore, expectant management of PROM in anticipation of spontaneous uterine contractions increases the changes of normal delivery without an increase in fetal and / or maternal morbidity.